INDIAN INCOME TAX RETURN. Assessment Year FORM

INDIAN INCOME TAX RETURN Assessment Year FORM ITR-7 For persons including companies required to furnish return under section 139(4A) or section 139(4B) or section 139(4C) or section 139(4D) (Please see Rule 12 of the Income-tax Rules,1962) (Also see attached instructions) 2 0 1 1-1 2 Part A-GEN GENERAL 1. PERMANENT ACCOUNT NUMBER (PAN) 2. NAME (As mentioned in deed of creation/ establishing/ incorporation/ formation) 3. ADDRESS (Flat No./Door/House No., Premises, Road, Locality) Pin Telephone Fax, if any 4. Date of formation (DD-MM-YYYY) 5. Status (Please see instructions) 6. e-mail ID: 7. Is there any change in Address? Yes No 8. Number and Date of registration under section 12A/12AA and 9. If claiming exemption under section 10: (i) Mention the clause(s) and sub-clause(s) (ii) Date of notification/ approval, if any (iii) Period of validity 10. Whether liable to tax at maximum marginal rate under section 164 Yes No 11. Ward/ Circle/ Range 12. Assessment Year - 13. Residential Status (Please see instructions) 14. If there is change in jurisdiction, state old Ward/ Circle/ Range 15. Section under which this return is being filed (Please see instructions) To Return of Income 16. Whether Original or Revised Return If revised, Receipt No. and date of filing original return. 17. Is this your first return? Yes No and For Office Use Only For Office Use Only Receipt No Date Seal and Signature of receiving official

18. Income from house property [Sch.-(F-1A)] PART-B (a) Computation of total income 19. (i) Profits and gains of business or profession [Sch.-(F-1B)] (ii) Profits and gains from transactions chargeable to securities transaction tax included in (i) above (Sch.-(B-26(ii)] 20. Capital gains (a) Short-term (under section 111A) [Sch.-F-1C(i)] (b) Short-term (others) [Sch.- F-1C(ii)] (c) Long-term [Sch.- F-1C(iii)] 21. Income from other sources [Sch.- F-1D] 22. Deemed income under section 11 [F-4(iv)] 23. Total [(18)+(19)+(20)+(21)+(22)] 24. Less: Exempt income [Sch.-F3(ix)] 25. Income chargeable under section 11(4) [Sch.-B(34)] 26. Total income [(23) (24)+(25)] In words (b) Statement of taxes on total income 27. Net agricultural income [Sch.F-9] 28. Tax on total income [Sch.G-6] 29. Surcharge, if applicable [Sch.G-7] 30. Education, including secondary and higher education cess [Sch.G-9] 31. Tax + Surcharge + Education Cess [Sch.G-10] 32. Tax deducted/ Collected at source [Sch.G-14B] 33. Advance tax paid [Sch.G-14A] 34. Self-assessment tax paid [Sch.G-14C] 35. Balance tax payable [(31) (32) (33) (34)] 36. Interest payable under section 234A/ 234B/ 234C [Sch.G-11] 37. Tax and interest payable [Sch.G-16] 38. Refund due, if any [Sch.G-17] Number of documents / statements attached Description In figures In words Description In figures In words a. TDS Certificates f. Applications for exercising options under section b. Audit report in Form No. 10B c. Audit report in Form No. 10BB 11(1) g. Form 10DB / 10DC h. Income / expenditure account and balance sheet

d. Audit Report under section 44AB e. Form No. 10 for exercising options under section 11(2) i. Others VERIFICATION I, (full name in block letters), son/ daughter of, holding permanent account number solemnly declare that to the best of my knowledge and belief, the information given in this return and the schedules, statements, etc., accompanying it is correct and complete and that the amount of total income/ fringe benefits and other particulars shown therein are truly stated and are in accordance with the provisions of the Income-tax Act, 1961, in respect of income chargeable to income-tax for the previous year relevant to the assessment year 2011-12. I further declare that I am making this return in my capacity as and I am also competent to make this return and verify it. Date: Place:.. Name and Signature SCHEDULE A. Income from house property In case of more than one house property, compute the income from each property on a separate sheet (to be attached to the return) and mention the aggregate figure against item No. 16 1. Number of sheets (in case of more than one property) Sheet No. 2. Address of the property (Flat No./Door/House No., Premises, Road, Locality/ Village, Town/ District, State/ Union territory in that order) 3. State whether the above-mentioned property is Pin Self-occupied or Let out or Unoccupied (Please tick as applicable) 4. Built-up area (In square metre) Area of land appurtenant (in square metre) Annual lettable value 5. Annual lettable value / Actual rent received or receivable (whichever is higher) 6. Less: Deduction claimed under section 23 (a) Taxes actually paid to local authority (b) Unrealised rent (c) 7. Total of 6 above 8. Balance {(5) (7)] 9. Less: Deductions claimed under section 24 (a) 30% of Annual value (b) Interest on capital borrowed 10. Total of 9 above 11. Balance [(8) (10)] 12. Unrealised rent received in the year under section 25A and / or 25AA 13. (a) Amount of arrears of rent received in the year under section 25B 0

(b) Less: Deduction admissible under section 25B (30% of arrear rent received) 14. Income chargeable under section 25B [13(a) 13(b)] 15. Balance [(11)+(12)+(14)] 16. Total of 15 (in case of more than one property, give total of all sheets) 17. Income chargeable under the head Income from house property (16) SCHEDULE B: Profits and gains of business or profession (I) General 1. Nature of business or profession: Manufacturing Trading Manufacturing-cum-trading Service Profession Others 2. Number of branches Attach list with full address(es).... 3. Method of accounting Mercantile Cash 4. Is there any change in method of accounting? Yes No 5. If yes, state the change.... 6. Method of valuation of stock 7. Is there any change in stock valuation method? Yes No 8. If yes, state the change: 9. Are you liable to maintain accounts as per section 44AA? Yes No 10. Are you liable to tax audit under section 44AB(a)/ (b)? Yes No 11. Are you liable to tax audit under section 44AB(c) read with section 44AD/ 44AE? Yes No 12. If answer to Item 10 or 11 is yes, have you got the accounts audited before the specified date? 13. If yes, whether audit report is furnished? Yes No If yes, give Receipt No and date of filing the same (also attach a copy) (II) Computation of income from business or profession other than speculation business (In case you have more than one business or profession and maintain separate books of account, attach separate sheet(s) giving computation for each such business or profession and show the aggregate figures against various items) Yes No 14. Net profit or loss as per consolidated profit and loss account 15. Add: Adjustment on account of change in method of accounting and / or valuation of stock For assessees having income covered under section 44AD / 44AE :- 16. (i) Add / Deduct profit / loss of business(es) included in item 14 under section indicated below, if answer to any of item 9, 11, 12 or 13 above is No.

(a) for section 44AD (b) for section 44AE Total (ii) In case you were engaged in the business mentioned in section 44AD: (a) Gross receipts (b) Net profit @ 8% of gross receipt (c) Add: Higher of the amounts mentioned in (i)(a) and (ii)(b) above (iii) In case you owned not more than ten goods carriages and were engaged in the business of plying, hiring or leasing of such carriages as mentioned in section 44AE: (a) heavy goods vehicle (b) other goods carriages Number of Vehicles / carriages Number of months during which owned Total Deemed profit under section 44AE (c) Add: Higher of the amount mentioned in (i)(b) above and the amount determined above as deemed profit under section 44AE 17. Deduct Amount of exempt income included in item 14, being: (i) Share of income from firm(s) exempt under section 10(2A) (ii) Share of income from AOP / BOI (iii) Any other income exempt from tax (specify the section) 18. Is section 10A / 10B/ 10C applicable? Yes No If yes, have you opted out by filing declaration prescribed under section 10A(8) / 10B(8) / 10C(6) If no, furnish the following information Section Year Amount claimed deductible / not includible in total income Yes No Deduct: Amount as per item 18 above 19. Add: Incomes specified in section 28(ii) to 28(vi) not included in item 14 20. Add: Deemed income not included in item 14 under sections 33AB, 33ABA, 35ABB, etc. Total (i) Section Amount (ii) Section Amount (iii) Section Amount (iv) Section Amount

21. Deduct: Allowance under section 35A, 35AB, 35ABB, etc. Section Year No. Installment Amount debited in accounts Amount allowable Total 22. Add: Adjustment on account of profit includible under section 44B, 44BB and 44BBA 23. Add / deduct: Adjustments in accordance with sections 28 to 44DA, if any, necessary Total Under section...... Amount...... 24. Add / deduct: Adjustment on account of current depreciation debited in books of account, and allowable as per the Act 25. Add / deduct: Adjustment on account of scientific research expenses under section 35(1)(iv) 26. (i) Profits and gains of business or profession other than speculation business (ii) Profits and gains from the transactions chargeable to securities transaction tax included in (i) above 27. Speculation profit / loss 28. Add / deduct: Net statutory adjustments 29. Profits and gains from speculation business 30. Deduct: Brought forward speculation loss, if any 31. Net profits and gains from speculation business (III) Computation of income from speculation business 32. Income chargeable under the head profits and gains [26(i) + 31] [Negative figure in item 31 not to be considered] (IV) Computation of income chargeable to tax under section 11(4) 33. Income as shown in the accounts of business undertaking [refer section 11(4)] 34. Income chargeable to tax under section 11(4)(32) (33) 599 SCHEDULE C: Capital Gains Separate sheets may be used and attached to the return in case of more than one short-term / long-term asset. The aggregate figure may be shown against item No.12 A. Short-term Asset B. Long-term Asset 1. Number of sheets (in case of more than one asset only) 2. Particulars of asset transferred

3. Date of acquisition (DD-MM-YYYY) 4. Date of Transfer (DD-MM-YYYY) 5. Mode of transfer 6. Full value consideration accrued or received 7. Deductions under section 48 (i) cost of acquisition (ii) cost of improvement (iii) expenditure on transfer 8. Total of 7 above 9. Balance [(6) (8)] 10. Exemption under section 11(1A) 11. Balance [(9) (10)] [Please specify short-term under section 111A / others] 12. Total of 11 (in case of more than one short / long term asset, give total of all sheets) 13. Deemed short-term capital gain on depreciable assets (section 50) 14. Income chargeable under the head Capital gains A. Short term [(12)+(13)] B. Long term (12) C. Short-term under section 111A included in 14A 0 D. Short-term (others) (14A 14C) SCHEDULE D. Income from other sources 0 0 1. Income other than from owning race horse(s):- (a) Dividends (b) Interest (c) Rental income from machinery, plants, buildings, etc. (d) Voluntary contributions / donations including donations for the corpus (e) Others 2. Total of 1 above 3. Deductions under section 57:- (a) Depreciation.. (b). (c). 4. Total of 3 above 5. Balance [(2) (4)]

6. (a) Income from owning and maintaining race horses (b) Expenses / Deductions under section 57 7. Balance income from owning and maintaining race horse(s) [6(a) 6 (b)] 8. Winnings from lotteries, crossword puzzles, races, etc. [see section 115BB] 9. Income chargeable under the head Income from other sources [(5) + (7) + (8)] [Negative figure, if any, in item 7 shall not be considered here] SCHEDULE E: Statement of set off of current year s losses under section 71 Fill in this schedule only if there is loss from any of the following sources for set-off against income from any other source; else, write N.A. 1. Amount of loss arising from house property [see item A-17] 2. Amount of loss from business (excluding speculation loss) [see item B-26] 3. Amount of loss from other sources (excluding loss from race horses) [see item D-5] 0 0 0 S.No. Head/ Source of income Loss to be adjusted 1. House Property 2. Business (including speculation profit) Income of previous year House property loss of the previous year set off Business loss (other than speculation loss) of the previous year set off Other sources loss (other than loss from owning race horses) of the previous year set off Current year s income remaining after set off (i) (ii) (iii) (iv) (v) 3. Short-term capital gain 4. Long-term capital gain 5. Other sources (including profit from owning race horses but excluding winnings from lottery) Under column (i), write only the positive incomes from the heads/ sources of income mentioned in rows (1) to (5) Under columns (ii), (iii) and (iv) write the appropriate amount of loss against the head / source of income with which it is set-off. 0 1. A. Income from house property [Sch. A-17 or E.1.(v)] SCHEDULE F. Statement of Total Income B. As per books of account Profits and gains of business or profession [Sch. B-33 or E.2.(v)] C. Capital gains (i) Short-term under section 111A [Sch. C.14C]

(ii) Short-term (others) [Sch. C.14D] (iii) Long-term [Sch. C.14B] D. Income from other sources [Sch. D.9 or E.5.(v)] 2. Total [(A) to (D)], i.e., Gross income 3. Deduct: 4. Add: (i) Amount applied to charitable or religious purposes in India during the previous year (ii) Amount deemed to have been applied to charitable or religious purposes in India during the previous year clause (2) of the Explanation to section 11(1) (iii) Amount accumulated or set apart / finally set apart for application to charitable or religious purposes to the extent it does not exceed 15 per cent of income derived from property held in trust wholly or in part only for such purposes under 11(1)(a) (iv) Amount eligible for exemption under section 11(1)(c) (v) Amount eligible for exemption under section 11(1)(d) (vi) Amount in addition to the amount referred to in (iii) above accumulated or set apart for specified purposes if all the conditions in section 11(2) are fulfilled (vii) Income claimed exempt under section 10( ), specify clause / sub-clause (..) (..) (viii) Income claimed/ exempt under section 13A in case of a political party (also fill schedule LA) (ix) Total [(i) to (viii)] (i) Income chargeable under section 11(1B) (ii) Income chargeable under section 11(3) (iii) Income in respect of which exemption under section 11 is not available by reason of provisions of section 13 (iv) Income chargeable under section 12(2) (v) Total [(i)+(ii)+(iii)+(iv)] 5. Add: Income from profits and gains of business or profession chargeable to tax under section 11(4) [Sch.B.34] 6. Gross total income [(2) (3)+(4)+(5)] 7. Deduction under Chapter VIA 8. Total income [(6) -(7)] 9. Net Agricultural income for rate purpose 10. Income included in items 8 above chargeable at special rates / maximum marginal rates Nature of income Section under which chargeable Amount of income Rate of Tax Amount of Tax 0

11. Total income chargeable at normal Rates 12. Total income chargeable at special Rates 0 13. Anonymous donations to be taxed under section 115BBC @ 30% 14. Total income chargeable at maximum marginal rates 1. Tax on total income (a) At special rates (b) At normal rates (c) At maximum marginal rate (d) Under section 115BBC 2. Tax on total income [1(a)+1(b)+1(c)+1(d)] 3. Tax payable under section 115JB [Sch.J-6] 4. Higher of 2 and 3 SCHEDULE G. Statement of taxes on total income 5. Credit under section 115JAA of tax paid in earlier years [Sch.JA-4] 6. Tax payable after credit under section 115JAA [(4)-(5)] 7. Surcharge [on (6) above] 8. Tax + Surcharge [(6)+(7)] 9. Education, including secondary and higher education cess [on (8) above] 10. Tax + surcharge + Education cess [(8) + (9)] 11. Add interest for: (a) Late filing of return under section 234A (b) Default in payment of advance tax under section 234B (c) Deferment of advance tax under section 234C 12. Total of items 11 above 13. Total tax and interest payable [(10) + (12)] 14. Prepaid taxes A. Advance tax Name of the Bank Branch BSR Code of Bank Branch (7 Digit) Date of deposit (DDMMYY) Serial No. of challan Amount (Rs.) Date of Upto 15/9 16/9 to 15/12 16/12 to 15/03 16/03 to 31/03 Total

installment Amount B. Tax deducted / collected at source: [Attach certificate(s)]: (a). (b). (c). Total of [(a) to (c)] C. Tax on self-assessment Name of the Bank BSR Code of Bank Branch Branch (7 Digit) Date of deposit (DDMMYY) Serial No. of challan Amount (Rs.) Total self-assessment tax paid D. Other prepaid taxes, if any (Please specify and attach proof) 15. Total [14(A) + 14(B) + 14(C) + 14(D)] 16. Tax and interest payable [(13) (15)] 17. Refund due, if any [(15) (13)] SCHEDULE H. General Information 1. In case of change in address, please furnish new address (tick): A. Residence or B. Office Flat / Door / Block No. Name of Premises / Building / Village Road / Street / Lane / Post Office Area / Locality / Taluka / Sub-Division Town / City / District State / Union territory Pin 2. Particulars of Bank Account (Mandatory in Refund cases) Name of the Bank MICR Code (9 digit) Address of Bank Branch Type of Account (Savings/ Current) Account Number ECS (Y/N) 3. Income claimed exempt: Nature of income Amount (in Rs) Reasons for claim

4. If claiming exemption under sub-clause (iiiad) or (iiiae) or (vi) or (via) of clause (23C) of section 10, state the amount of aggregate annual receipts 5. State the nature of charitable or religious or educational or philanthropic objects/ activities 6. Are you assessed to wealth-tax? Yes No (If yes, the wealth tax return should be filed along with this return) SCHEDULE I. Details of amounts accumulated / set apart within the meaning of section 11(2) in the last eleven years, viz., previous years relevant to the current assessment year and the ten preceding assessment years Year of accumulation Amount accumulated Whether invested in accordance with the provisions of section 11(5) Purpose of accumulation Amounts applied during the year Balance amount available for application Amount deemed to be income within meaning of subsection (3) of section 11 SCHEDULE J. Book Profits under section 115JB 1. Net profit as shown in the profit and loss account for the relevant previous year section 115JB(2) 2. Adjustments (if any) vide the first and second proviso to section 115JB(2) 3. Adjustments vide Explanation to section 115JB(2) Nature of item Add Deduct 4. Total adjustments [(2) + (3)] 5. Balance book profit [(1) + (4)] 6. 15% of the book profit SCHEDULE JA: Tax credit under section 115JAA Sl.No. Item Assessment Year 2010-11 Assessment Year 2011-12 (i) (ii) (iii) (iv) 1. Tax under section 115JB 0 0 2. Tax under other provisions of 0 0

the Act 3. Excess tax under 115JB 4. Excess tax under other provisions of the Act 0 0 [1(iii) 2(iii)] if 1(iii) is more than 2(iii) + brought forward MAT credit for A.Y. 2007-08, 2008-09 and 2009-10 = 3(v)] [1(iv) 2(iv)] if 1(iv) is more than 2(iv) 0 [2(iv) 1(iv) if 2(iv) is more than 1(iv) 5. Tax credit under section 115JAA.[Lower of 3(v) and 4(iv)] 0 SCHEDULE K. Statement showing the investment of all funds of the Trust or Institution as on the last day of the previous year Part A Details of investment/ deposits made under section 11(5) (may be given in a separate sheet if space is not sufficient) Part B Investments held at any time during the previous year(s) [in concern in which persons referred to in section 13(3) have a substantial interest] Sl. No. Name and address of the concern Where the concern is a company, No. and class of shares Nominal value of the investment Income from the investment Whether the amount in col. 4 exceeds 5 per cent of the capital of the concern during the previous year say Yes / No 1 2 3 4 5 6 Total Part C Other investments as on the last day of the previous year(s) Sl.No. Name and address of the concern Where the concern is a company, class No. and nominal value of of shares held investment 1 2 3 4 SCHEDULE L. Statement of particulars regarding the Author(s) / Founder(s) / Trustee(s) / Manager(s), etc., of the Trust or Institution 1. Name(s) of author(s) / founder(s) / and address(es), if alive

2. Date on which the trust was created or institution established or company incorporated 3. Name(s) of the person(s) who was / were trustee(s) / manager(s) during the previous year(s) 4. Name(s) of the person(s) who has / have made substantial contribution to the trust / institution in terms of section 13(3)(b) 5. Name(s) of relative(s) of author(s), founder(s), trustee(s), manager(s), and substantial contributor(s) and where any such author, founder, trustee, manager or substantial contributor is a Hindu undivided family, also the names of the members of the family and their relatives SCHEDULE LA (In case of a Political Party) 1. Whether books of account were maintained? Yes No 2. Whether record of each voluntary contribution in excess of twenty thousand rupees (including name and address of the person who has made such contribution) were maintained 3. Whether the accounts have been audited, if yes date of audit Yes Yes No No 4. Whether the report under sub-section (3) of section 29C of the Representation of the People Act, 1951 for the financial year has been submitted Yes No